CAJ | 학술논문

目的探讨十二指肠神经内分泌癌(duodenal neuroendocrine carcinoma,DNEC)的临床病理学特征与外科治疗效果.方法回顾性分析2009-2012年于我院治疗的8例DNEC的临床病理学特征与外科治疗效果并复习文献.结果8例DNEC中,男性5例,女性3例;发病年龄28~80岁,平均年龄53岁;主要临床表现为皮肤巩膜黄染5例,上腹及腰背部疼痛5例,黑便1例,1例无症状;肿瘤位于十二指肠降段4例,乳头3例,水平段1例;腹部影像呈多样性,CT可呈十二指肠乳头或相应部位肿物.4例行胰十二指肠切除术,2例行内窥镜逆行胆总管造影并胆管支架置入术(ERCP),2例行胃肠吻合并超声引导经皮经肝胆道造影置管引流术(PTCD);术后随访3~40个月,4例行根治性切除患者均长期存活,4例行姑息性治疗患者均已死亡.结论十二指肠神经内分泌癌呈浸润性生长,应积极手术治疗以改善患者预后.
목적탐토십이지장신경내분비암(duodenal neuroendocrine carcinoma,DNEC)적림상병이학특정여외과치료효과.방법회고성분석2009-2012년우아원치료적8례DNEC적림상병이학특정여외과치료효과병복습문헌.결과8례DNEC중,남성5례,녀성3례;발병년령28~80세,평균년령53세;주요림상표현위피부공막황염5례,상복급요배부동통5례,흑편1례,1례무증상;종류위우십이지장강단4례,유두3례,수평단1례;복부영상정다양성,CT가정십이지장유두혹상응부위종물.4례행이십이지장절제술,2례행내규경역행담총관조영병담관지가치입술(ERCP),2례행위장문합병초성인도경피경간담도조영치관인류술(PTCD);술후수방3~40개월,4례행근치성절제환자균장기존활,4례행고식성치료환자균이사망.결론십이지장신경내분비암정침윤성생장,응적겁수술치료이개선환자예후.
Objective To study the clinicopathological features of duodenal neuroendocrine carcinoma (DNEC) and its surgical treatment outcome. Methods Clinical data about 8 DNEC patients and its surgical treatment outcome were retrospectively analyzed with its related literature reviewed. Results Of the 8 DNEC patients, 5 were males and 3 were females. They developed DNEC at the age of 53 years (mean 28-80 years). DNEC was mainly manifested as jaundice in 5 cases, as abdominal pain in 5 cases, and as melena in 1 case. No symptom was observed in 1 case. The tumor was located at descendant duodenum in 4 cases, at duodenal papilla in 3 cases, at horizontal duodenum in 1 case. CT scan showed DNEC at duodenal papilla or its corresponding sites. Of the 8 patients, 4 underwent pancreaticoduodenectomy, 2 underwent ERCP and bile duct stenting, 2 underwent gastroenterostomy and PTCD. The patients were followed up for 3-40 months after operation. The 4 patients who underwent radical excision were still alive while the other 4 patients who underwent palliative therapy died. Conclusion DNEC is an infiltrative growth tumor. Surgical resection can improve the prognosis of its patients.